Creekside Counseling Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CREEKSIDE COUNSELING CENTER, LLC

Practice address

132 S. Broad St. #101
Canfield, OH 44406

Phone

(330) 533-5450

Fax

(330) 533-4292

NPI assigned

May 19, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thomas Richard Kupec, PSY.D, LPCCNPI 1457320889

Title

Director/Owner

Phone

(330) 533-5450

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Richard Kupec, PSY.D, LPCC

  • Mental Health Counselor
  • Canfield, OH
  • NPI 1457320889
  Medicare reassignment NPD Authorized official
• Anne Lally, LPCC-S

  • Mental Health Counselor
  • Canfield, OH
  • NPI 1225168149
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1518192608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S. BROAD ST. #101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "44406",
            "telephone_number": "330-533-5450",
            "fax_number": "330-533-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S. BROAD ST. #101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "44406",
            "telephone_number": "330-533-5450",
            "fax_number": "330-533-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "KUPEC",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "330-533-5450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D, LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E-0003444-SUPV",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Counseling, LLC
• John Christopher Cox, D.O.
• David Andrew Crans, D.D.S.
• Cassandra Crawford
• Linda S. Crawford, CT
• Creekside Counseling Center, LLC
• Terrance B Crogan, MA MS CAGS
• Julie Cross, DPT
• Bethany A Crouch
• Sharon Cuchacovich Francos, MFT-T

• Mental Health Counselor in Canfield, OH
• Providers in Canfield, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.